Hargis v. Commissioner of Social Security
Filing
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Memorandum Opinion and Order: The decision of the Administrative Law Judge is affirmed, and this case is dismissed in its entirety with prejudice (Related document 1 ). Signed by Magistrate Judge George J. Limbert on 7/21/17. (S,AA)
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
MICHAEL HARGIS,
)
)
Plaintiff,
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)
v.
)
)
)
NANCY A. BERRYHILL1,
ACTING COMMISSIONER OF SOCIAL )
SECURITY ADMINISTRATION,
)
)
Defendant.
)
)
CASE NO. 1:16CV1071
MAGISTRATE JUDGE
GEORGE J. LIMBERT
MEMORANDUM OPINION
AND ORDER
Plaintiff Michael Hargis (“Plaintiff”) requests judicial review of the final decision of the
Commissioner of Social Security Administration (“Defendant”) denying his application for
disability insurance benefits (“DIB”). ECF Dkt. #1. In his brief on the merits, filed on September
9, 2016, Plaintiff asks the Court to review whether the administrative law judge’s (“ALJ”) decision
is supported by substantial evidence. ECF Dkt. #16. On November 9, 2016, Defendant filed a
response brief. ECF Dkt. #18. Plaintiff did not file a reply brief.
For the following reasons, the Court AFFIRMS the decision of the ALJ and dismisses the
instant case in its entirety with prejudice.
I.
PROCEDURAL HISTORY
Plaintiff filed an application for DIB in July 2012. ECF Dkt. #12 (“Tr.”) at 148.2 In the
application, Plaintiff alleged disability beginning on July 7, 2011. Id. at 150. This claim was denied
initially and upon reconsideration. Id. at 12. Plaintiff then requested a hearing before an ALJ, which
was held on August 7, 2014. Id. at 27. On December 19, 2014, the ALJ denied Plaintiff’s
1
On January 23, 2017, Nancy A. Berryhill became the acting Commissioner of Social Security,
replacing Carolyn W. Colvin.
2
All citations to the Transcript refer to the page numbers assigned when the Transcript was filed as
a .PDF, rather that the page numbers assigned by the CM/ECF system. When the Transcript was filed the
.PDF included an index, with the indexed pages differentiated from the numerical pages. Accordingly, the
page number assigned in the .PDF mirrors the page number printed on each page of the Transcript, rather than
the page number assigned when the Transcript was filed in the CM/ECF system.
application for DIB. Id. at 12. Subsequently, the Appeals Council denied Plaintiff’s request for
review of the ALJ’s decision. Id. at 1. Accordingly, the decision issued by the ALJ on December
19, 2014, stands as the final decision.
On May 4, 2016, Plaintiff filed the instant suit seeking review of the ALJ’s decision. ECF
Dkt. #1. Plaintiff filed a brief on the merits on September 9, 2016. ECF Dkt. #16. Defendant filed
a response brief on November 9, 2016. ECF Dkt. #18. Plaintiff did not file a reply brief.
II.
SUMMARY OF RELEVANT PORTIONS OF THE ALJ’S DECISION
In the decision issued on December 19, 2014, the ALJ found that Plaintiff met the insured
status requirements of the Social Security Act through December 31, 2016. Tr. at 14. Continuing,
the ALJ determined that Plaintiff had not engaged in substantial gainful activity since July 7, 2011,
the alleged onset date. Id. The ALJ found that Plaintiff had the following severe impairments:
asthma; obstructive sleep apnea; obesity; hypertension; history of pulmonary embolism; right arm
basilica vein thrombophlebitis and deep vein thrombosis; depressive disorder; and panic disorder.
Id. Following an analysis of Plaintiff’s severe impairments, that ALJ determined that Plaintiff did
not have an impairment or combination of impairments that met or medically equaled the severity
of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. at 15. In making
this determination, the ALJ analyzed Plaintiff’s activities of daily living, social functioning,
concentration, persistence, or pace, and episodes of decompensation. Id. at 16.
In activities of daily living, the ALJ found that Plaintiff had mild restriction. Specifically,
the ALJ noted that Plaintiff: lived with his wife and adult daughter; participated in household chores
including washing laundry, cleaning, and taking out the trash; reported some difficulties with selfcare that were secondary to his physical limitations; maintained a driver’s license and was able to
drive a car; reported that he left his home minimally, but that this was primarily due to his breathing
problems; was independent in his ability to manage his medical care and finances; and did not allege
any mental difficulties in adhering to a schedule or routine during his last period of employment.
Tr. at 16.
The ALJ determined that Plaintiff had moderate difficulties in social functioning. Tr. at 16.
Namely, the ALJ indicated that Plaintiff: reported some difficulties being around crowds due to
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panic attacks; denied a history of difficulty getting along with others in school or past work
environments; spent time visiting his family members if their schedules allowed; and went to his
mother-in-law’s home to visit. Id. Further, the ALJ stated that the consultative examining
psychologist, Mitchell Wax, Ph.D., noted some difficulty regarding Plaintiff’s ability to
communicate direct responses during questioning, which required some redirection, but that he was
otherwise polite and cooperative. Id. The ALJ also noted that there was no evidence that Plaintiff
experienced any difficulty interacting with treating sources or field office representatives, and that
there was likewise no evidence that he had difficulty during the hearing. Id. Additionally, the ALJ
indicated that, despite his complaints of irritability during treatment in early 2014, Plaintiff referred
to himself during the hearing as a generally “quiet person” and admitted that he typically did not
have problems with others. Id.
With regard to concentration, persistence, or pace, the ALJ found that Plaintiff had moderate
difficulties. Tr. at 16. The ALJ indicated that Plaintiff presented as alert and oriented at the
consultative examination and that Dr. Wax noted that Plaintiff did not have difficulty maintaining
attention and concentration during the examination, but noted that his self-reported lack of
persistence in household chores was due to his physical limitations. Id. Further, the ALJ stated that
Plaintiff told Dr. Wax that he was fired from his most recent job because of missing work due to
physical problems and anxiety, but elsewhere Plaintiff’s reports had not indicated that anxiety was
a problem while he was working and his treatment records from around the time he stopped working
did not corroborate his statement. Id. Additionally, the ALJ stated that Plaintiff’s treating sources
noted that he was cooperative and attentive, with no gross behavioral abnormalities, and that he
admitted at the hearing that he was able to concentrate enough to follow a one-hour television show
and that he had to rise and move during this one-hour period due solely to his physical impairments.
Id. As for episodes of decompensation, the ALJ stated that Plaintiff had not experienced any
episodes of decompensation of extended duration. Id.
After considering the record, the ALJ found that Plaintiff had the residual functional capacity
(“RFC”) to perform light work as defined in 20 C.F.R. § 404.1567(b), with the following limitations:
the requirement of a sit/stand option every hour for five minutes without leaving the workstation;
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occasionally balance, stoop, kneel, crouch, crawl, and climb ramps or stairs; cannot climb ladders,
ropes, or scaffolds; can reach in all directions and can handle, finger, and feel; preclusion from
workplace exposure to extreme temperatures, humidity, and concentrated levels of pulmonary
irritants; must avoid workplace hazards such as unprotected heights or moving machinery; could
perform simple routine tasks with simple, short instructions; could make simple work-related
decisions; could only tolerate few workplace changes; and limited to superficial interaction with coworkers, supervisors, and the public. Tr. at 17.
When discussing the RFC determination, the ALJ stated that, after careful consideration of
the evidence, she found that Plaintiff’s medically determinable impairments could reasonably be
expected to cause the alleged symptoms, however, his statements concerning the intensity,
persistence, and limiting effects of his symptoms were not entirely credible. Tr. at 18. First, the
ALJ indicated that the objective clinical evidence was inconsistent with Plaintiff’s allegations of
disabling mobility limitations due to shortness of breath. Id. The ALJ noted that pulmonary
function testing demonstrated only a mildly restrictive ventilator deficit, and that a sleep study
showed obstructive sleep apnea with “remarkable” improvement in Plaintiff’s respiratory events and
arterial oxygen desaturation with continuous positive airway pressure (“CPAP”) therapy. Id.
Continuing, the ALJ indicated that although Plaintiff had a history of pulmonary embolism and deep
vein thrombosis around the time of the alleged onset date, with recurrence in November 2011,
testing for a recurrence of these conditions in May 2012 was negative. Id. The ALJ also stated that
Plaintiff’s physical examinations were also relatively unremarkable, specifically mentioning the
March 22, 2012, physical examination revealing that Plaintiff’s lungs were clear, respirations were
even and non-labored, and that percussion of the chest was normal. Id. After stating the above, the
ALJ determined that the examination findings and diagnostic results appeared inconsistent with
Plaintiff’s reports regarding his ability to walk only fifty yards at a time. Id.
Next, the ALJ stated that the evidence also failed to support Plaintiff’s allegations of lower
extremity edema that limited his ability to sit, stand, or walk for prolonged periods. Tr. at 18.
According to the ALJ, the available evidence regarding Plaintiff’s physical impairments spanned
only from the onset date until May 2012. Id. at 18-19. The ALJ stated that there were occasions
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in the record where treating sources noted no edema, including a notation from Plaintiff’s treating
pulmonologist from March 22, 2012. Id. at 19. Continuing, the ALJ indicated that Plaintiff’s most
recent physical examination, performed in the context of an emergency visit for acute chest pain on
May 17, 2012, demonstrated 2+ non-pitting edema in the lower extremities. Id. The ALJ also stated
that despite Plaintiff’s allegation that he must prop up his legs while he sits, there was only one
instance in which a treating source recommended that Plaintiff elevate his legs, and that there was
no indication that this was a permanent functional limitation. Id. Further, the ALJ indicated that
there was no evidence that a treating source recommended activity restrictions secondary to
Plaintiff’s impairments. Id.
The ALJ next stated that Plaintiff’s treatment history was also inconsistent with what would
be expected in the case of an individual with the symptoms and limitations alleged. Tr. at 19.
According to the ALJ, the evidence corroborated Plaintiff’s allegations of a somewhat sudden onset
of his severe impairments at the time of the alleged onset date in July 2011, with some recurring
complications over the following months requiring emergency visits and/or brief hospitalizations.
Id. The ALJ indicated that, despite Plaintiff’s continued reports of debilitating shortness of breath
throughout the relevant period, the available evidence demonstrated that he last sought treatment of
any kind for his condition in May 2012, and that the significant gap in treatment from that time until
the date of the decision suggests that his impairments were not as bothersome or limiting as alleged.
Id. The ALJ also stated that the evidence demonstrated that Plaintiff responded to appropriate
treatment methods, including CPAP therapy, an inhaler, and prescription medications for asthma and
anticoagulation. Id. Also noted by the ALJ was the fact that there was no evidence that a physician
had prescribed an ambulatory aid despite Plaintiff’s allegation of debilitating shortness of breath that
limited his ability to walk even fifty yards. Id.
As for Plaintiff’s mental health, the ALJ stated that the objective evidence and treatment
history failed to corroborate Plaintiff’s allegations of disabling depression and anxiety. Tr. at 19.
The ALJ indicated that Plaintiff actually denied experiencing depression and anxiety to treating
sources on several occasions. Id. Further, the ALJ stated that Plaintiff only sought mental health
treatment in February 2014, which suggested that his symptoms had not been as bothersome or
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limiting as alleged. Id. Additionally, the ALJ noted that: Plaintiff did not require stabilization for
disruptive mental health symptoms; there was no evidence of suicidal ideation, paranoia,
hallucinations, or abnormal though processes or behavior; and that Plaintiff had not required
inpatient hospitalization for mental health reasons at any time prior to or during the relevant period.
Id. at 20.
Next, the ALJ indicated that Plaintiff testified that he last worked in November 2011 and left
due to his illness. Tr. at 20. The ALJ stated that while the certified earnings record did not reflect
wages past 2011, Plaintiff had indicated that he was employed “part-time” as recently as his visit
with a physician on March 22, 2012. Id. As noted by the ALJ, Plaintiff also described his
employment status as “part-time” during two prior visits with his pulmonologist, as well as during
an emergency room visit on January 12, 2012. Id. The ALJ stated that while this may have been
a miscommunication rather than an intentional effort to mislead, this evidence suggested that
Plaintiff may not have been a fully accurate historian with respect to his work history. Id.
Continuing, the ALJ indicated that Plaintiff’s activities of daily living were inconsistent with his
allegations regarding his functional limitations, specifically noting that he was able to participate
in light household chores, and that he maintained a driver’s license and was able to leave his home
independently. Id.
As for opinion evidence, the ALJ stated that no treating physician, psychiatrist, or
psychologist offered an opinion regarding Plaintiff’s work-related limitations. Tr. at 20. As such,
the ALJ indicated that she had given considerable weight to the opinion of the state agency medical
consultant, Leon D. Hughes, M.D., who opined that Plaintiff was capable of a range of light
exertional work activity with postural and environmental limitations accounting for his asthma and
obesity. Id. Regarding Plaintiff’s mental health limitations, the ALJ considered the examining
opinion offered by Dr. Wax. Id. at 21. The ALJ indicated that Dr. Wax assigned a global
assessment of functioning (“GAF”) score of fifty-one and opined that Plaintiff was able to
understand instructions and maintain attention, but would not respond appropriately to superiors,
co-workers, or work pressures. Id. After reciting the substance of Dr. Wax’s opinion, the ALJ
stated that the opinion was entitled to only some weight as it was based heavily on Plaintiff’s
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subjective allegations during the one-time examination. Id. Further, the ALJ indicated that the
medical evidence of record failed to demonstrate that Plaintiff was unable to get along with others
or respond to stress appropriately, specifically noting that treating sources consistently noted that
he was alert, oriented, and cooperative, with no cognitive or communicative deficits.
Id.
Additionally, the ALJ stated that the Dr. Wax’s assignment of a GAF score of fifty-one was
internally inconsistent with his opinion that Plaintiff would be unable to interact with others or deal
with stress, and that Dr. Wax’s opinion was inconsistent with evidence demonstrating that Plaintiff
left his most recent employment for reasons stemming primarily from his physical health. Id.
Continuing, the ALJ explained that she gave more weight to the opinion of the state agency
psychological consultant, Paul Tangeman, Ph.D., who opined that Plaintiff was capable of carrying
out simple, sustained tasks without strict time pressures and involving only superficial interaction
with others. Id. The ALJ stated that Dr. Tangeman’s opinion was consistent with the limited
evidence at the time of the determination, which consisted primarily of Dr. Wax’s consultative
examination findings. Id.
After the discussion of Plaintiff’s RFC, the ALJ determined that Plaintiff was unable to
perform any past relevant work. Tr. at 21. The ALJ indicated that Plaintiff was a younger
individual on the alleged onset date, had a high school education and was able to communicate in
English, and that the transferability of job skills was not material to the determination of disability
because the Medical-Vocational Rules supported a finding that he was not disabled. Id. at 22.
Considering Plaintiff’s age, education, work experience, and RFC, the ALJ determined that jobs that
Plaintiff could perform existed in significant numbers in the national economy. Id. In conclusion,
the ALJ found that Plaintiff had not been under a disability, as defined in the Social Security Act,
from July 7, 2011, the alleged onset date, through the date of the decision. Id. at 23.
III.
STEPS TO EVALUATE ENTITLEMENT TO SOCIAL SECURITY BENEFITS
An ALJ must proceed through the required sequential steps for evaluating entitlement to
social security benefits. These steps are:
1.
An individual who is working and engaging in substantial gainful activity
will not be found to be “disabled” regardless of medical findings (20 C.F.R.
§§ 404.1520(b) and 416.920(b) (1992));
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2.
An individual who does not have a “severe impairment” will not be found to
be “disabled” (20 C.F.R. §§ 404.1520(c) and 416.920(c) (1992));
3.
If an individual is not working and is suffering from a severe impairment
which meets the duration requirement, see 20 C.F.R. § 404.1509 and
416.909 (1992), and which meets or is equivalent to a listed impairment in
20 C.F.R. Pt. 404, Subpt. P, App. 1, a finding of disabled will be made
without consideration of vocational factors (20 C.F.R. §§ 404.1520(d) and
416.920(d) (1992));
4.
If an individual is capable of performing the kind of work he or she has done
in the past, a finding of “not disabled” must be made (20 C.F.R. §§
404.1520(e) and 416.920(e) (1992));
5.
If an individual’s impairment is so severe as to preclude the performance of
the kind of work he or she has done in the past, other factors including age,
education, past work experience and residual functional capacity must be
considered to determine if other work can be performed (20 C.F.R. §§
404.1520(f) and 416.920(f) (1992)).
Hogg v. Sullivan, 987 F.2d 328, 332 (6th Cir. 1992). The claimant has the burden to go forward
with the evidence in the first four steps and the Commissioner has the burden in the fifth step. Moon
v. Sullivan, 923 F.2d 1175, 1181 (6th Cir. 1990).
IV.
STANDARD OF REVIEW
Under the Social Security Act, the ALJ weighs the evidence, resolves any conflicts, and
makes a determination of disability. This Court’s review of such a determination is limited in scope
by §205 of the Act, which states that the “findings of the Commissioner of Social Security as to any
fact, if supported by substantial evidence, shall be conclusive.” 42 U.S.C. §405(g). Therefore, this
Court’s scope of review is limited to determining whether substantial evidence supports the findings
of the Commissioner and whether the Commissioner applied the correct legal standards. Abbott v.
Sullivan, 905 F.2d 918, 922 (6th Cir. 1990).
The substantial-evidence standard requires the Court to affirm the Commissioner’s findings
if they are supported by “such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.” Cole v. Astrue, 661 F.3d 931, 937, citing Richardson v. Perales, 402 U.S.
389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971) (citation omitted). Substantial evidence is defined
as “more than a scintilla of evidence but less than a preponderance.” Rogers v. Comm’r of Soc. Sec.,
486 F.3d 234 (6th Cir. 2007). Accordingly, when substantial evidence supports the ALJ’s denial
of benefits, that finding must be affirmed, even if a preponderance of the evidence exists in the
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record upon which the ALJ could have found plaintiff disabled. The substantial evidence standard
creates a “‘zone of choice’ within which [an ALJ] can act without the fear of court interference.”
Buxton v. Halter, 246 F.3d 762, 773 (6th Cir.2001). However, an ALJ’s failure to follow agency
rules and regulations “denotes a lack of substantial evidence, even where the conclusion of the ALJ
may be justified based upon the record.” Cole, supra, citing Blakely v. Comm’r of Soc. Sec., 581
F.3d 399, 407 (6th Cir.2009) (citations omitted).
V.
ANALYSIS
Plaintiff asserts that the ALJ’s decision was not supported by substantial evidence because
the RFC finding was not an accurate assessment of his specific mental and physical limitations.
ECF Dkt. #16 at 11-14. First, Plaintiff avers that Dr. Wax: diagnosed him with panic disorder with
agorophobia and depressive disorder; opined that he would not respond appropriately to supervisors
or co-workers in a work setting; noted that he distorted questions and did not answer questions
directly; opined that he would not respond appropriately to work pressures in a work setting due to
panic disorder; and stated that he became anxious and was not able to attend work on a regular basis.
ECF Dkt. #16 at 12. Continuing, Plaintiff indicates that he presented to Said Abou Haidar, M.D.,
for a complete psychiatric evaluation sixteen months after Dr. Wax performed his evaluation. Id.
Plaintiff indicates that he reported that he was experiencing depression with increased irritability,
decreased sociability, difficulty with sleep, weight gain, difficulty with concentration, and panic
attacks with acute periods of intense fear or discomfort. Id. At this evaluation, Dr. Haidar
diagnosed Plaintiff with major depressive disorder (single episode, severe) and panic disorder, and
assigned a GAF score of forty-five. Id. Plaintiff states that Dr. Haidar noted that his symptoms had
not abated and assigned a GAF score of forty-five at a follow-up visit. Id.
Next, Plaintiff asserts that the ALJ unreasonably found that Dr. Wax’s opinion was only
entitled to some weight, and that the ALJ improperly stated that the opinion was based heavily on
Plaintiff’s subjective allegations during a one-time evaluation. Tr. at 12. Plaintiff claims that it is
apparent that the ALJ did not consider the factors set forth in 20 C.F.R. § 404.1527(c). Id. at 12.
Continuing, Plaintiff asserts that Dr. Wax did not rely simply on Plaintiff’s subjective allegations,
and that Dr. Wax’s report is fully consistent with the report of Dr. Haidar. According to Plaintiff,
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Dr. Wax’s report and Dr. Haidar’s report, taken together, provide longitudinal evidence that he
suffered from serious symptoms resulting from his mental impairment. Id. at 12-13. Plaintiff also
asserts that the ALJ’s statement that Dr. Wax’s opinion was inconsistent with evidence that he left
his most recent employment for reasons primarily associated with his physical health is not a valid
reason to reject the opinion. Id. at 13. Specifically, Plaintiff avers that he testified that his
depression began due to problems with his blood clots, and that, in fact, Plaintiff reported to Dr.
Wax that he had no difficulty getting along with others when working. Id. According to Plaintiff,
this evidence demonstrates that Plaintiff’s symptoms arose after he stopped working and continued
to worsen. Id.
Moving on, Plaintiff asserts that the ALJ did not even afford full weight to the opinion of the
non-examining state agency psychological consultant, Dr. Tangeman. Tr. at 13. Plaintiff states that
the ALJ omitted significant limitations found by Dr. Tangeman when assessing Plaintiff’s RFC. Id.
Specifically, Plaintiff indicates that the ALJ omitted Dr. Tangeman’s opinion that he may require
extra supervisory redirection and did not include the assessment that his contact with others should
be brief. Id. Plaintiff asserts that the ALJ’s decision was not supported by substantial evidence due
to these omissions. Id.
Regarding his physical limitations, Plaintiff avers that the ALJ wrongly determined that the
record did not support his allegations of lower extremity edema that would limit his ability to stand,
sit, or walk for prolonged periods. ECF Dkt. #16 at 14. Plaintiff claims that the ALJ’s RFC
assessment did not accommodate his need for a sit/stand option every hour for a period of five
minutes or his need to elevate his legs throughout the workday. Id. Further, Plaintiff claims that
the ALJ’s RFC findings did not take into account his inability to respond appropriately to the public,
co-workers, and supervisors. Id. For these reasons, Plaintiff asserts that there is not substantial
evidence in the record supporting the ALJ’s finding that he was capable of performing a significant
number of jobs, and thus he should be found to be disabled. Id.
Defendant contends that substantial evidence supports the ALJ’s RFC determination. ECF
Dkt. #18 at 5-11. First, Defendant addresses Plaintiff’s physical limitations, indicating that the
record only contained two opinions regarding Plaintiff’s physical ability to perform work. Id. at 8.
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Defendant indicates that the ALJ considered the opinions provided by the state agency physicians,
who each opined that Plaintiff was capable of performing work at the light exertional level, with
certain additional limitations, as well as updated evidence offered after the opinions were issued.
Id. at 8-9. According to Defendant, the ALJ took into account the only two opinions offered
regarding Plaintiff’s physical limitations, and then further limited the RFC finding based on updated
evidence, such as Plaintiff’s testimony. Id. at 9.
Moving on to Plaintiff’s mental limitations, Defendant asserts that the ALJ considered the
treatment notes as well as the opinions of Mel Zwissler, Ph.D., and Dr. Tangeman, and accounted
for these opinions in the RFC finding. ECF Dkt. #18 at 9. Specifically, Defendant notes that Dr.
Zwissler and Dr. Tangeman opined that Plaintiff: could carry out sustained tasks to completion
without strict times pressures; could interact in brief, simple, superficial ways; and did not feel
comfortable going out in public. Id. Additionally, Defendant states that Plaintiff’s mental health
examinations routinely showed Plaintiff to be alert, oriented, and cooperative, and with intact
memory, concentration, judgment, and insight. Id. Defendant asserts that there was no evidence
that Plaintiff experienced suicidal ideation, paranoia, hallucinations, or abnormal thought processes
or behavior, or that he had been hospitalized for mental health reasons. Id. at 9-10. According to
Defendant, these opinions were consistent with Plaintiff’s ability to perform mental work-related
functions at his prior jobs. Id. at 10. Defendant also notes that although Plaintiff told Dr. Wax that
he was fired due to physical problems and anxiety, treatment notes show that Plaintiff did not
experience anxiety until after his termination. Id.
Next, Defendant contends that the ALJ reasonably assigned Dr. Wax’s opinion little weight
because the opinion was internally inconsistent, inconsistent with the evidence as a whole, and based
on Plaintiff’s subjective complaints during a single examination. ECF Dkt. #18 at 10. Defendant
indicates that it is significant that no other physician opined that Plaintiff would be unable to respond
to work pressures, and, to the contrary, the record is replete with opinions that Plaintiff had only
mild difficulties in maintaining concentration, persistence, or pace. Id. For example, Defendant
states that although Dr. Tangeman noted moderate limitations in Plaintiff’s ability to maintain
concentration, persistence, or pace, he concluded that Plaintiff was still capable of carrying out
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sustained tasks to completion without strict time pressures. Id. Based on the reasons stated above,
Defendant asserts that the ALJ’s RFC finding was reasonable, and that her decision should be
affirmed. Id. at 11.
Plaintiff’s arguments are without merit. The ALJ’s assignment of some weight to Dr. Wax’s
opinion was not improper because it was based on substantial evidence. First, the ALJ indicated that
Dr. Wax’ opinion was based heavily on Plaintiff’s subjective complaints made during a single
evaluation. Tr. at 21. A reading of Dr. Wax’s opinion confirms the ALJ’s statement, as the sections
of Dr. Wax’s opinion titled “Summary and Conclusions” and “Functional Assessment” mainly
paraphrase Plaintiff’s statements or directly quote Plaintiff. See id. at 387-88. Moving on, the ALJ
correctly stated that Plaintiff’s treating sources consistently noted that he was alert, oriented,
cooperative, and without cognitive of communicative deficits. See id. at 17-21, 229, 242, 386-88,
390, 392. The ALJ also correctly indicated that there was no evidence of panic attacks or related
symptom exacerbation due to stress that required physician intervention. Id. at 21. Further, the ALJ
determined that Dr. Wax’s opinion was internally inconsistent as he assigned a GAF score of fiftyone, indicating moderate symptoms or some difficulty in social/occupational functioning, but then
opined that Plaintiff would be unable to interact with others or deal with stress. Id.
Plaintiff asserts that “it is apparent that the ALJ did not consider the factors set forth in 20
C.F.R. § 404.1527(c).” ECF Dkt. #16 AT 12-13. Despite Plaintiff’s assertion, the ALJ did consider
the factors set forth in 20 C.F.R. § 404.1527(c).3 The ALJ addressed the examining and treating
relationship between Plaintiff and Dr. Wax when discussing the severity of Plaintiff’s impairments
and his RFC. Tr. at 16, 21. As for supportability and consistency, the ALJ addressed these issues
when explaining the reasons why only some weight was afforded to the opinion of Dr. Wax. Id. at
21. Plaintiff does not indicate that Dr. Wax has any specialization that the ALJ failed to address.
Finally, insofar as Plaintiff claims that Dr. Haidar’s opinion was consistent with Dr. Wax’s opinion
and thus tends to support the latter, the ALJ noted multiple sources constituting substantial evidence
3
20 C.F.R. § 404.1527(c) indicates that the following factors will be considered when weighing a
medical opinion: (1) examining relationship; (2) treatment relationship; (3) supportability; (4) consistency;
(5) specialization; and (6) other factors which tend to support or contradict the opinion.
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contradicting Dr. Wax’s opinion. See id. at 16-21. The fact that Dr. Wax’s opinion was supported
by Dr. Haidar’s opinion, but contradicted by the other opinions of record, does not establish that the
ALJ was required to provide greater weight to Dr. Wax’s opinion.
Further, Plaintiff does not assert that Dr. Wax was a treating source, instead referring to him
properly as a “[c]onsultative examiner.” ECF Dkt. #16 at 12. This classification was correct since
Dr. Wax examined Plaintiff a single time prior to preparing his opinion. Accordingly, no special
analysis is required beyond a determination as to whether the ALJ’s findings were supported by
substantial evidence. See 42 U.S.C. § 405(g). The ALJ provided substantial evidence explaining
why she afforded only some weight to Dr. Wax’s opinion, and was under no obligation to do more.
Plaintiff also claims that the ALJ improperly found that Dr. Wax’s opinion regarding Plaintiff’s
limitations was inconsistent with evidence demonstrating that he left his last employment for reasons
associated primarily with his physical health. ECF Dkt. #16 at 13. While there is evidence in the
record both supporting and contradicting this minor portion of the ALJ’s opinion, Plaintiff’s
argument is moot as, for the reasons described above, the ALJ’s decision was supported by
substantial evidence.
Plaintiff also asserts that the ALJ omitted portions of Dr. Tangeman’s opinion, namely, that
he may need extra supervisory redirection and should have only brief contact with co-workers
supervisors, and the public. ECF Dkt. #16 at 13. Dr. Tangeman was a state agency psychological
consultant, rather than a treating physician, and thus the ALJ was subject to the same substantial
evidence standard when assessing Dr. Tangeman’s opinion, as described above. The ALJ relied on
substantial evidence when assigning “more weight” to Dr. Tangeman’s opinion, as she provided the
following reasons for the weight assigned: the opinion was consistent with the evidence available
to Dr. Tangeman; Plaintiff received limited treatment for mental health concerns; there was no
history of mental health treatment at the time of the alleged onset date; and the opinion was
consistent with Plaintiff’s history regarding his ability to perform his most recent employment. Tr.
at 21. The ALJ was under no obligation to accept Dr. Tangeman’s opinion that Plaintiff may need
extra supervisory redirection and should have only brief contact with co-workers, supervisors, and
the public. See 42 U.S.C. § 405(g). In fact, the ALJ did include the limitation that Plaintiff be
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limited to superficial interaction with co-workers, supervisors, and the public, so it appears that
Plaintiff, at least as to this point, is concerned only with the ALJ’s omission of the word “brief.”
The ALJ was not required to explicitly address every piece of evidence in the record. Thacker v.
Comm’r of Soc. Sec., 99 Fed.Appx. 661, 665 (6th Cir. 2004). The ALJ’s omission of these two
relatively minor portions of Dr. Tangeman’s opinion does not render the ALJ’s decision unsupported
by substantial evidence, as suggested by Plaintiff. Rather, the ALJ considered Dr. Tangeman’s
opinion, explained the level of weight assigned to the opinion, and adopted the portions of the ALJ’s
opinion that she found were supported by the record. The ALJ’s actions do not constitute error.
Plaintiff also briefly asserts that the ALJ wrongly determined that the record did not
support his allegations of lower extremity edema that would limit his ability to stand, sit, or walk
for prolonged periods. ECF Dkt. #16 at 14; see Tr. at 18-19. Continuing, Plaintiff claims that
although the ALJ indicated that Plaintiff required a sit/stand option for five minutes every hour,
she improperly included that Plaintiff would not be required to leave the workstation. Id.
Plaintiff does not rely on the only opinions offered as to his physical limitations, submitted by
Elizabeth Das, M.D., and Dr. Hughes, the state agency reviewing physicians, and does not speak
as to how the ALJ improperly assessed these opinions. See ECF Dkt. #16 at 14. Instead,
Plaintiff cites to instances in the record where his edema is discussed and the Mayo Clinic’s
website, where it is stated that elevation and movement are “life style and home remedies” that
may decrease edema. Id.
Plaintiff fails to cite any medical opinion indicating that Plaintiff must be allowed to
leave his workstation or elevate his leg throughout the day, instead apparently suggesting that the
ALJ should have done independent research on medical techniques that “may help decrease
edema and keep it from coming back.”4 No precedent is cited for such a proposition. The ALJ
discussed Plaintiff’s edema, as presented in the record, stated that his activities of daily living
4
See ECF Dkt. #16 at 14 (citing Mayo Clinic, Edema - Lifestyle and home remedies,
http://www.mayoclinic.org/diseases-conditions/edema/basics/lifestyle-home-remedies/con-20033037 (last
visited July 19, 2017)); The undersigned is aware that it was advised that Plaintiff “take adequate rest with
elevation of the left leg.” Tr. at 352. Plaintiff does not cite this portion of the record, and, as stated above,
there was no indication in the record that this a was a permanent functional limitation.
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were inconsistent with his allegations regarding his functional limitations, and explained that the
opinion of Dr. Hughes, which indicated that Plaintiff was capable of a range of light work with
certain limitations, was supported by substantial evidence. Tr. at 18, 19-20. Plaintiff has failed
to show that it was error for the ALJ to exclude the above discussed limitations in her RFC
finding. For the reasons stated above, Plaintiff has failed to show that the ALJ’s decision is not
supported by substantial evidence.
VI.
CONCLUSION
For the foregoing reasons, the Court AFFIRMS the decision of the ALJ and dismisses the
instant case in its entirety with prejudice.
Date: July 21, 2017
/s/George J. Limbert
GEORGE J. LIMBERT
UNITED STATES MAGISTRATE JUDGE
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